Problem with approval??

[ASBgirl 53]

I had my last appointment today so supposedly they will submit my surgery to insurance for approval tomorrow.

With my new UHC insurance they cover the surgery 100% after $250 deductable if you have a 5 year history of obesity AND a BMI of 35 or greater. I have met these requirements. I saw the surgeon for the first time 2/14/2011.

Someone mentioned to me that since I am so new on my insurance policy that it might be denied due to pre-existing condition. I looked in my insurance book and here is what is says " Expenses incurred as a result of an injury or illness for which medical advise , diagnosis,care, or treatment was recommended or received during the six-month period before the coverage effective date under the plan, will be considered a "pre-existing condition" and will not be covered under the plan during the first 12 months of coverage.

Since I did not seek treatment for the condition until 2/14/2011 and my policy started 1/31/2011 I do not think the pre-existing condition thing will apply to me. What do you think?? I am so anxious to find out as I just new this was going to happen but now that the pre-existing condition thing was brought to my attention I am FREAKING out with fear of being denied.

[ldydrgnkpr 49]

Have you called and spoke with the bariatric coordinator? Were you assigned a case manager? It wouldn't hurt to call and ask. I have UHC as well and I called and asked a lot of questions. Just a suggestion.

Deb

[ASBgirl 53]

"Have you called and spoke with the bariatric coordinator? Were you assigned a case manager? It wouldn't hurt to call and ask. I have UHC as well and I called and asked a lot of questions. Just a suggestion.

Deb"]

This may sound silly but I am almost afraid to call them and ask about the pre-existing because I do not want to point out anything that may give them a reason to deny me. I guess I am going to have to break down and call anyway thought!

[karaserene1985 1]

I also have UHC and it sounds like we have a similar policy. Mine will also be covered 100% minus my $250 copay for the hospital stay. I have had my insurnace since June 2010 so it has been less then a year and i have met with doctors for years to discuss my obesity so for me it is a pre-existing condition. My information was sent to insurance yesterday and i was approved yesterday. I would do the same as Deb suggested which is to call the case manager who is working on your file and ask lots of questions. Over the course of my 6 months of supervised diet, I probably called her 10 times and she was always, always, very happy to answer and help with my questions.

Good luck!

Kara